"Medicine is a social science, and politics is nothing else but medicine on a large scale"—Rudolf Virchow

June 18, 2017

THIRUVANANTHAPURAM: With eight more people succumbing to fever on Saturday, the official number of deaths due to viral fever in the state has risen to 55, even though unofficial figures indicate a higher death toll. Those who died on Saturday included a soldier referred to the Medical College Hospital from the Pangode Military Station here.

JAIPUR: Chikungunya, the vector-borne disease has turned into a nightmare to city dwellers with 40 fresh cases were detected on Tuesday.

According to the official figures of health department, the number of Chikungunya cases has gone up to 418 till now with no signs of abating. Hospitals are flooded with patients complaining of chikungunya and viral fever. Chief minister Vasundhara Raje is also down with viral fever.

Commissioner, medical and health Dr BR Meena said that his department is adopting multi prong approach to deal with the situation. He further said that while, along with anti-larval activities like fogging, the department has also initiated biological controls like releasing gambusia fish in water bodies to control the breeding of mosquitoes.

"Under the chief ministers Jal Swalamban scheme many water bodies were constructed and most of them have collected water due to the good rainfall during this monsoon season. These water bodies have also become breeding ground for mosquitoes," said Meena. He said the health department had advised the government to release gambusia fish which thrives on mosquito larva as part of the biological control programme, besides enhancing the number of doctors at hospitals.

He said an additional OPD has been opened at SMS hospital to deal with the rush and six additional doctors have been posted at Jaipuria and Gangori Bazar hospitals in the city. He said the government had already made laboratory test of Chikungunia and dengue free of cost apart from extending this facility to all district hospitals.

PUNE: A chikungunya-like viral fever, mostly affects women, has left medical practitioners in the city flummoxed.

Patients with this type of illness exhibit symptoms similar to that of chikungunya. However, their blood samples test negative when specific tests are run.

Notably, this atypical viral fever mainly affects people from upper class, upper middle class, middle class and working professionals. Peculiar enough, the patients also develop black pigmentation particularly at the tip of their nose during the course of the illness.

"Around 90% of my patients are currently that of atypical viral fever. Among them, 70% are exhibiting chikugunya-like viral fever symptoms while the rest that of dengue-like viral fever," said senior family physician Avinash Bhondwe, former president of Indian Medical Association (IMA), Pune branch.

Initially, there were more patients with dengue-like viral fever, complaining of muscle pain. "Towards the end of June, there were more cases of dengue-like viral fever and the trend continued thereafter. However, since the beginning of this month, chikungunya-like viral fever is on the rise," Bhondwe added.

Recently, a seminar in the city had to be postponed as the main speakers at the event, mainly doctors, were down with the chikungunya-like viral fever.

Family physician Mahesh Wayal said, "There has been a spurt in the cases of this atypical viral fever across the city. Cases are more commonly seen in women than men. It is my observation that for every seven patients suffering from the disease, four are women."

Fortunately, no special medical treatment is required for patients with atypical viral fever.

The simple antipyretic drugs like paracetamol and non-steroidal anti-inflammatory drugs are required to relieve the symptoms. In some patients, analgesic medicines has to be used for joint pains.

"A close observation of the patient's white blood cells (WBC) and platelet counts is required. Usually, a patient gets well within a week," family physician Prakash Mahajan said.

Physician Nitin Bora, who practises in Padmavati, said, "I am seeing quite a few patients exhibiting chikungunya-like symptoms starting with high fever followed by a severe joint pain. Gradually, they develop rash all over the body. Peculiarly, in a few cases, patients had black spots on the tip of their nose which disappeared within 15-20 days without any treatment."

August 23, 2016

An Indian athlete who returned from the Rio Olympics with fever and body ache is being treated in isolation at a hospital in Bengaluru, where a full medical investigation is on to rule out the Zika virus.

Sudha Singh, 30, returned to India on Saturday and was taken to a hospital as she complained of joint pain and fatigue and her blood pressure plunged.

She had participated in the steeplechase competition.

Ms Singh's blood samples have been sent to a virology institute for Zika testing. Doctors say they want to be extra cautious since she was in Brazil where the virus is a major concern.

"It is probably just a viral infection but as protocol, we are investigating to rule out Zika," Dr SR Sarala, a senior scientific officer at the Sports Authority of India told NDTV.

Marathon runners OP Jaisha and Kavita Raut, who were Sudha's roommates in Rio, are also said to be showing milder symptoms of a viral infection. The Sports Authority wanted Jaisha in hospital too, but she went home to Kerala, said officials.

"It is respiratory droplet infection," said Dr Sarala, explaining that the three shared the room and are all vulnerable to infection.

Sudha is recovering and doing better than when she was first admitted, say doctors.

This is a somewhat confusing report. Indian media are fond of vague terms like "viral infection" and "viral fever," and if Zika is suspected, this would be the first case I'm aware of that spreads by respiratory droplets.

Nearly three months after a U.S. warplane repeatedly attacked a hospital – immolating patients in their beds and destroying the sprawling Médecins sans frontières facility with sustained heavy gunfire for nearly 30 minutes – the Obama administration is hoping a presidential apology and vague claims that it was all a terrible mistake will defuse calls for an independent international probe into war-crimes allegations.

But neither MSF (Doctors Without Borders) nor leading human-rights organizations such as Human Rights Watch are willing to accept the Pentagon’s claim that a series of blunders resulted in the brightly lit and well-marked hospital being destroyed in the otherwise blacked out Afghan city of Kunduz.

MSF has delivered a petition bearing more than half-a-million signatures to the White House calling for an international probe, and Human Rights Watch wants senior U.S. officers investigated to determine whether they are criminally accountable.

At least 42 patients and staff were killed in the Oct. 3 attack. Dozens more were seriously wounded, including some who were mowed down as they fled the rapid-firing machine guns on the circling AC-130U Spooky gunship overhead.

“Perpetrators cannot also be judges,” Jason Cone, executive director for MSF in the United States, said to a small gathering of demonstrators holding searing images of the attack before delivering the petition.

MSF wants the Obama administration to drop its opposition to an International Humanitarian Fact-Finding Commission investigation because the Bern-based UN entity can’t act without the express consent of those being investigated. Perhaps not surprisingly, the commission hasn’t investigated a single alleged war crime in its 24-year history, despite claiming that its “main purpose is to investigate allegations of grave breaches and serious violations of international humanitarian law.”

Mr. Cone said the President could underscore the need for all warring countries – not just the United States – to respect the Geneva Conventions, which among other things make it a war crime to attack a hospital, by agreeing to an IHFFC probe.

“There is the principle of consenting to independent scrutiny,” Mr. Cone said, adding: “Establishing the facts is also incredibly important, and examining those facts through the lens of international humanitarian law rather than simply whether they adhered to U.S. military procedure.”

Days after the attack, which the U.S. military initially justified by claiming the Taliban had taken over the hospital, Mr. Obama called MSF’s International President Joanne Liu to offer a brief, but private, apology.

Asked whether he offered any explanation about why the hospital, which was on the U.S. military’s protected “no-strike” list, was attacked, Mr. Obama’s spokesman Josh Earnest said: “He did not.”

July 23, 2015

City doctors are seeing an increased number of viral encephalitis cases, with patients displaying symptoms like high-grade fever, severe headache, and even sensitivity to light, convulsions and altered behaviour in some cases.

Dr Pratit Samdani, who practises at Saifee, Bhatia and other hospitals, has admitted six patients in six days. "All my patients are between 14 to 21 years of age," he said. A 14-year-old patient under him, Ravish Seth, had such a severe headache that he could not even lift his head up.

"Tests revealed that there was an infection in the brain," said Nayana, Ravish's mother. Ravish is stable and will be discharged in a day or two.

In another case, a 21-year-old Kajal Mehta was rushed to Bhatia Hospital with severe headache. "She was unable to stay calm even for a moment," said her father, Mukhesh.

Dr Hemant Gupta, who practises at JJ Hospital and Bombay hospital, said patients need to be put on antiedema (inflammation) drugs and steroids at times. "These are cases wherein the virus attacks the brain and the key to prevent is better immunity," said Gupta who has admitted three patients in the last week.

Dr Satish Pawar, the state's head of the directorate of health services, said viral encephalitis cases are reported round the year, mainly from the Vidharbha region. "We have not received any report from the BMC about rise in the cases in Mumbai as of now," he added. Doctors warn that if left untreated, viral encephalitis patients may develop memory loss, paralysis and may even land up in coma.

July 12, 2015

AHMEDABAD: Does your child have high fever with white patches on tongue and red rashes on the body? If yes, then he might be suffering from a strange viral fever that has raised its head in the city.

The city has reported 218 such cases in last two weeks. Since June 24, pediatrician Dr Mona Desai has seen 15 cases where kids aged between 3 and 5 were down with high fever ranging between 102 and 104 degrees Fahrenheit.

"There's a huge possibility of a strange fever that is causing strange symptoms. The fever was persistent for a week. Even if the fever subsides a bit, it strikes back after a few hours. This is quite baffling," Dr Desai said.

Pediatrician Dr Nidhish Nanavati has been examining almost 24 similar cases per day for the last one week. "I see 80 kids a day, of which 30% have such strange symptoms," Dr Nanavati told TOI.

He said: "The high fever and red rashes are mainly due to the sudden change in weather. The city witnessed heavy downpour last month and there has been a dry spell since then. As kids have a low immunity level, they become the first victims of viral fever. I saw several such cases last year as well."

Asarwa Civil Hospital has also received 20 strange viral fever cases in less than a fortnight. "In some cases, we had to straightaway put the patients on a drip," said Dr M M Prabhakar, medical superintendent, Civil Hospital.

Another pediatrician Dr Parag Parikh has seen 15 such cases over the past two weeks. "In all cases, the fever is so stubborn that it initially doesn't even respond to drugs. Kids drool everywhere, lose appetite and shed one to two kgs of weight."

March 24, 2014

Aid workers and public health officials are battling to contain west Africa's first outbreak of the deadly Ebola virus as tests on suspected cases in Conakry allayed fears that it had spread to the capital.

At least 59 people have died in an outbreak of the virulent virus raging through Guinea's southern forests but tests on three haemorrhagic fever cases - two of them fatal - in Conakry were negative, the government said.

"The Pasteur Institute in Dakar worked urgently all last night on samples taken from suspected cases here in Conakry, which were all negative," Sakoba Keita, the health ministry's chief disease prevention officer, said on Monday.

"So for now, there's no Ebola in Conakry, but haemorrhagic fever whose nature remains to be determined."

The UN Children's Fund (UNICEF) said in a statement on Sunday that the Ebola virus "has quickly spread from the communities of Macenta, Gueckedou, and Kissidougou to the capital, Conakry".

Keita said however that the Pasteur Institute was still working on identifying the virus behind the fever cases in the capital and would know more "in the coming hours".

Officials from the health ministry and the World Health Organization (WHO) met on Sunday in Conakry for urgent talks on the crisis.

It's not exactly a relief to know that Conakry is dealing with yet another hemorrhagic disease.

June 12, 2013

Thiruvananthapuram: Taking steps to combat the fever situation in the state, the government has said that vacancies of doctors are being filled on an urgent basis and fogging machines will be bought in all municipalities and panchayats. The public health labs will function on Sundays also.

Meanwhile, three fever related deaths were reported in the state on Tuesday of which two were from Kollam and one from Thiruvananthapuram. About 18,911 fever cases, 101 confirmed dengue and two confirmed cases of leptospirosis were also reported.

Health minister V.S. Sivakumar said that from now on the public health labs will function on Sundays also. He was speaking to the media after a high level meeting convened by Chief Minister Oommen Chandy.

Mr Sivakumar said, “Sanction has been given to all panchayats and municipalities to buy fogging machines. All DMOs will be asked to buy them in all districts. The platelet incubator, order for which has been placed, will be received this week.”

I understand leptospirosis and dengue, but what is "fever"? Is it the viral fever I also see in many reports? If so, it's entirely too vague to be a useful term. Whatever it is, it appears to afflict only people in India, and I'm surprised that India's healthcare system hasn't clarified the question.